Immediate effects of foot orthoses on gait biomechanics in individuals with persistent patellofemoral pain.

Abstract

BACKGROUND:

The efficacy of foot orthoses in reducing patellofemoral pain (PFP) is well documented; however, the mechanisms by which foot orthoses modulate pain and function are poorly understood.

RESEARCH QUESTION:

This within-subject study investigated the immediate effects of foot orthoses on lower limb kinematics and angular impulses during level walking and stair ambulation in individuals with persistent PFP.

METHODS:

Forty-two participants with persistent PFP (≥3 months duration) underwent quantitative gait analysis during level walking, stair ascent and stair descent while using: (i) standard running sandals (control); and (ii) standard running sandals fitted with prefabricated foot orthoses. Hip, knee, and ankle joint kinematics and angular impulses were calculated and statistically analyzed using paired t-tests (p < 0.05).

RESULTS:

Relative to the control condition, foot orthoses use was associated with small but significant decreases in maximum ankle inversion angles during walking (mean difference [95% confidence interval]: -1.00° [-1.48 to -0.53]), stair ascent (-1.06° [-1.66 to -0.45]) and stair decent (-0.94° [-1.40 to -0.49]). Foot orthoses were also associated with decreased ankle eversion impulse during walking (-9.8Nms/kg [-12.7 to -6.8]), and decreased ankle dorsiflexion and eversion impulse during stair ascent (-67.6Nms/kg [-100.7 to -34.6] and -17.5Nms/kg [-23.6 to -11.4], respectively) and descent (-50.4Nms/kg [-77.2 to -23.6] and -11.6Nms/kg [-15.6 to -7.5], respectively). Ankle internal rotation impulse decreased when participants ascended stairs with foot orthoses (-3.3Nms/kg [-5.4 to -1.3]). Limited changes were observed at the knee and hip.

SIGNIFICANCE:

In individuals with persistent PFP, small immediate changes in kinematics and angular impulses - primarily at the ankle - were observed when foot orthoses were worn during walking or stair ambulation. The clinical implications of these small changes, as well as the longer-term effects of foot orthoses on lower limb biomechanics, are yet to be determined.

• Authors: Harvi F Hart, Kay M Crossley, Jason Bonacci, David C Ackland, Marcus G Pandy, Natalie J Collins
• Journal: Gait & posture (Gait Posture) Vol. 77 Pg. 20-28 (03 2020) ISSN: 1879-2219 [Electronic] England
• PMID: 31955047 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier B.V. All rights reserved.

Topics

• Adult
• Ankle Joint (physiopathology)
• Biomechanical Phenomena (physiology)
• Evaluation Studies as Topic
• Female
• Foot Orthoses
• Gait (physiology)
• Gait Analysis
• Hip Joint (physiopathology)
• Humans
• Knee Joint (physiopathology)
• Male
• Patellofemoral Pain Syndrome (physiopathology, therapy)
• Rotation
• Running (physiology)
• Stair Climbing (physiology)
• Treatment Outcome
• Walking